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Biomedical subjects

B Nyvad

Publications and source records attributed to B Nyvad.

At least 19 recordsLinked to original sources
PubMed1997

Assessing the stage of caries lesion activity on the basis of clinical and microbiological examination.

The dynamic nature of caries lesion progression may require that classification of caries lesions makes distinctions in activity status. The aim of the present review was to compile and discuss the literature which pertains to clinical assessment of caries lesion activity, and to examine whether recent developments in microbiological research may justify the use of microbiological methods for evaluation of caries activity. Clinical observations suggest that caries lesion progression can be arrested at any stage of lesion development, provided that clinically plaque-free conditions are obtained. However, there is no universal level of oral hygiene to be recommended. The diagnoses "active" and "inactive/arrested" caries have been validated by a range of histological and chemical methods which have supported a separation into distinct clinical categories. Simple microbiological methods have so far not been useful in differentiating between active and inactive caries lesions. Very few studies have evaluated the inter- and intraexaminer reliability of caries diagnostic criteria based on assessment of the activity state of lesions, but recent data indicate that active and inactive caries lesions can be diagnosed with a high degree of reliability. A decision-making tree for dental caries is presented by means of which it is possible to associate the assessment of caries lesion activity with an appropriate treatment modality. It is concluded that research into better methods of assessing caries lesion activity clinically should be stimulated.

Decision Trees↗
PubMed1994

Human experimental caries models: intra-oral environmental variability.

In situ caries models serve purposes other than just being a simpler way to obtain data than running a clinical trial. However, variation in information obtained not only among individuals but also, in particular, depending on different locations of the models within the oral cavity have so far been given little attention. In the present review, the aim has been to characterize the different designs of in situ caries models and to describe some important factors which may vary within the oral cavity and thus influence the outcome of the way the different in situ models are used. Advantages and disadvantages of in vivo models vs. in situ models are discussed. In the latter case, the distinction is made between dental appliance models and so-called "single tooth" models. The review concludes that in situ models differ distinctly with regard to their "biological potential". Because of regional differences in salivary film velocity, pH, and composition of the microflora, results obtained by the various models are not likely to be immediately comparable. Moreover, local factors in relation to specimen environment, such as degree of "protection" and plaque thickness, may further add to the differences. It is suggested that these observations are important in considerations of the relevance of substituting clinical trials with in situ studies. Because of the pronounced intra-oral variation in certain parameters thought to be important for caries lesion development, we conclude that no in situ model can, by itself, fulfill the role as the "model of choice". Finally, although in situ models are useful adjuncts in attempts to estimate the relative effects of new anticaries methods or compounds on caries initiation, the selection of in situ study model design will strongly depend on the aim and purpose of the study.

Dental Caries↗
PubMed1991

Active and inactive root surface caries lesions in a selected group of 60- to 80-year-old Danes.

In 90, 60- to 80-year-old patients with teeth retained in both jaws (mean 20.4 +/- 4.3), a total of 1,092 root surface lesions were recorded. Of these 156 were diagnosed as active caries lesions, whereas 509 were considered inactive, and 427 were filled. About 60% of the elderly had one or more active lesions and 79% had fillings. Seventy percent had more than 8 filled or carious (active or inactive) surfaces. The percentage of carious and filled root surfaces in relation to surfaces at risk demonstrated that the buccal surfaces of lower molars and premolars and upper canines were the most severely affected (RCI = 70%) with fillings predominating on easily accessible surfaces. A constant relationship between active and inactive lesions was found on all other surfaces but third molars and upper incisors. The data suggest that active and inactive root caries lesions must be diagnosed as separate entities if the dynamic nature of root surface caries is to be explored in epidemiological studies and clinical trials.

Aged↗
PubMed1991

A quantitative analysis of mineral loss and shrinkage of in vitro demineralized human root surfaces.

Demineralization of dentin specimens proceeds at a faster rate than that of enamel. Although this is generally accepted, a quantification of the rate of formation of root lesions is hampered by the shrinkage of the lesions when these are dried prior to microradiographic analysis. This leads to a significant underestimation of the lesion depth and total mineral loss. The aim of this paper was to quantitate the rate of mineral loss during root lesion formation in vitro and to determine the shrinkage of root specimens as a result of drying. Unerupted roots of human teeth were subjected to a demineralizing system of 0.1 mol/L lactate buffer (pH = 4.8) with 0.2 mmol/L methanehydroxydiphosphonate during four, 11, 22, and 44 days. The root lesions were assessed by quantitative microradiography. The demineralizing solutions were analyzed to determine the amounts of root tissue dissolved. A comparison of these two sets of data showed that, with the demineralizing system used, root lesions may shrink up to 62%. Fixation of the specimens in fixative did not affect this shrinkage. Chemical analysis showed that mineral loss proceeded linearly with time. From the data-sets of this study, a model was developed to compensate for the shrinkage in the dentin specimens. In this way, it was possible to calculate the lesion depth at four demineralization times as being 130, 220, 320, and 530 microns, respectively. These values were in agreement with a microscopic determination of the lesion depth.

Decalcification Technique↗
PubMed1990

Microflora associated with experimental root surface caries in humans.

This study describes the microflora from actively progressing root surface caries lesions, in which mineral loss had been determined by quantitative microradiography. The caries lesions were produced experimentally in root surface specimens from human molars inserted in lower partial dentures carried for 3 months by six elderly individuals. A total of 780 bacterial isolates were identified from 13 plaque samples, collected with a punch technique, and six dentin samples. The composition of the microflora showed distinct individual differences. The microflora from plaque samples associated with the highest mineral loss was dominated by either Actinomyces viscosus or a combination of mutans streptococci (serotypes c, d, and f) and Lactobacillus species (L. casei and L. brevis). Plaque from root surfaces with less pronounced mineral loss harbored a more complex microflora comprising gram-positive rods, mutans streptococci, Streptococcus mitis biovar 1, Veillonella spp., gram-negative rods, and low numbers of lactobacilli. In the latter samples, individual variations in the proportions of mutans streptococci (serotypes c, d, and g), Actinomyces species (A. viscosus and A. naeslundii), and Veillonella parvula biotypes were observed. These findings suggest that certain species or combinations of species are more cariogenic than others and that dominance of single acidogenic species in particular is conducive to high caries activity.

Aged↗
PubMed1990

Ability to bind salivary alpha-amylase discriminates certain viridans group streptococcal species.

A collection of 144 viridans group streptococcal strains recently characterized as part of a taxonomic study was examined for the ability to bind salivary alpha-amylase. This property was found in most strains of Streptococcus gordonii and Streptococcus mitis and in occasional strains of Streptococcus anginosus and Streptococcus salivarius. In contrast, all strains of Streptococcus sanguis, Streptococcus oralis, Streptococcus vestibularis, and Streptococcus mutans lacked alpha-amylase-binding capacity. A rapid and easy assay described in this paper may be an important supplementary test for identification of oral streptococci.

Bacteriological Techniques↗
PubMed1990

Comparison of the initial streptococcal microflora on dental enamel in caries-active and in caries-inactive individuals.

This study compared the initial (4 h) microflora on enamel in 7 caries-active and in 7 caries-inactive adolescents. In both groups the microflora was dominated by streptococci which comprised 61 and 78% (median values) of the total viable counts in caries-active and caries-inactive individuals, respectively (p less than 0.01). Identification of a total of 700 streptococcal isolates according to a recently revised classification showed that the predominant streptococci belonged to the species Streptococcus oralis, Streptococcus mitis biovar 1, and Streptococcus sanguis. Early plaque from caries-inactive individuals differed from that of caries-active individuals by significantly higher proportions of S. sanguis (p less than 0.05) and IgA1 protease producing streptococci (p less than 0.05). In caries-active individuals, there was a tendency to elevated levels of S. mitis biovar 1 (p less than 0.10). In addition, caries-active individuals were colonized by significantly higher numbers of mutans streptococci on the enamel surfaces (p less than 0.01). However, in both groups Streptococcus mutans (serotype c) comprised less than or equal to 2% of the early streptococcal flora. Streptococcus gordonii, S. mitis biovar 2, and Streptococcus salivarius were present in low proportions and did not show differences in distribution that could be related to caries activity. The observed differences in the composition of the early streptococcal microflora may be a factor that governs the eventual cariogenic potential of dental plaque.

Adolescent↗
PubMed1990

An ultrastructural study of bacterial invasion and tissue breakdown in human experimental root-surface caries.

This study describes the structural features of the interface between microbial deposits and root cementum in actively progressing root-surface caries lesions developed experimentally in six elderly individuals. A total of 18 specimens was examined by microradiography, and a further 18 by light and transmission electron microscopy after intra-oral periods of one, two, and three months. All specimens showed various degrees of subsurface dissolution of mineral and bacterial invasion of the cementum. Although the microradiographic pattern of mineral loss was subsurface in nature, transmission electron microscopy showed dissolution of crystals in the outermost layers of the cementum, with a distinct gradient inward. Bacterial invasion occurred along the borders between bundles of relatively well-mineralized extrinsic collagen fibers in which the characteristic cross-banding remained intact. The pattern of bacterial invasion was influenced by the incremental lines and the cemento-dentinal junction. The invading bacteria were almost exclusively Gram-positive, of various shapes, and possessed thick, moderately electron-dense cell walls and electron-lucent "vacuoles" in the cytoplasm. It is concluded that because of pronounced mineral loss of the outermost cementum, accompanied by bacterial invasion, the surface of an active cementum caries lesion, as observed by transmission electron microscopy, is not identical to that seen in microradiograms.

Aged↗
PubMed1989

Structure of dental plaque and the plaque-enamel interface in human experimental caries.

This study describes the ultrastructure of dental plaque and the plaque-enamel interface after 2 and 3 weeks' exposure to a cariogenic challenge. Five dental students carried a total of 25 specimens of smooth surface enamel in intraoral acrylic appliances. During the initial 3 days the volunteers refrained from oral hygiene and performed nine daily mouthrinses with 10% (w/v) solutions of sucrose. After the 3rd day the volunteers cleaned their natural teeth, whereas the experimental sites were left undisturbed except for nine daily extraoral 5-min immersions in 5% (w/v) solutions of sucrose. Clinically, three patterns of colonization were observed after 3 days. At the histological level the experimental bacterial deposits also exhibited three distinctly different structural patterns after 2 and 3 weeks. Individual patterns consistently differed with regard to the microbial composition, the structural organization of the deposits, and the presence or absence of crystal-like material. However, in all individuals a layer of densely packed gram-positive bacteria resembling Actinomyces was consistently present close to the enamel surface. In 1 individual the microbial deposits were dominated by large bacteria, the ultrastructure of which conformed to the description of Stomatococcus mucilaginosus. These findings may partly explain pronounced individual variations in the rate of caries lesion development and progression in vivo.

Bacteria↗
PubMed1989

Microradiography of experimental root surface caries in man.

The aim of this study was to describe the pattern and rate of mineral loss during experimental root surface caries in situ without giving frequent sucrose rinses as a supplementary cariogenic challenge. Six elderly persons carried at total of 18 specimens of unerupted human root surface in recessions of lower partial dentures for 1, 2 and 3 months. Another six root surfaces served as controls. No cleaning of the specimens was allowed during the experimental period whereas the natural dentition was cleaned with a nonfluoride toothpaste. All the specimens, as observed by quantitative microradiography, exhibited subsurface caries lesions. Despite variation between individuals the depth of subsurface demineralization increased linearly with time, the average depth of the lesions being 240 microns after 1 month and 630 microns after 3 months. Delta MC, calculated as the difference in total mineral content between control and test specimens throughout the lesions, increased linearly with time from 2,000 to 8,400 vol% microns after 1 and 3 months, respectively. Preparation for microradiography induced a certain shrinkage of the lesions which resulted in an underestimation of the actual loss of mineral. It is concluded that this experimental model is suitable for studying the etiology and prevention of root surface caries provided the interindividual variation is taken into account.

Aged↗
PubMed1988

Organic structures of developmental origin in human surface enamel.

The aim of this study was to examine the distribution of organic material in mature enamel surfaces immediately prior to eruption. Thirty-six samples of buccal or lingual enamel from unerupted third molars were prepared for transmission electron microscopy by a method involving demineralization of the enamel after embedding in Epon. The results showed that at time of eruption human surface enamel is a highly porous structure containing large amounts of developmental protein which appear as a variety of triangular, funnel-shaped, or invaginated configurations extending into the enamel. The implications of this finding may be of importance to the understanding of early caries lesion formation in the enamel since organic structures may modify the diffusion of ions in and out of the tissue.

Crystallography↗
PubMed1987

Microbiology of the early colonization of human enamel and root surfaces in vivo.

This study describes the predominant early microflora on human teeth on the basis of microbiologic identification of 1742 fresh isolates. The isolates were obtained from four dental students who carried test pieces of enamel and root surface in the oral cavity for 4, 8, 12, and 24 h. During the experimental periods oral hygiene was discontinued. Under equal conditions root surfaces were more heavily colonized than were enamel surfaces. However, the composition of the microbiota was the same. Within the first 24 h the microflora was dominated by streptococci and Gram-positive pleomorphic rods. S. sanguis contributed only 6-18% of the early colonizers whereas S. mitis and S. oralis varied between 24-42% and 1-27% (mean values), respectively. The relative proportion of S. oralis increased significantly within the observation period while the proportion of S. salivarius and arginine-positive S. mitis showed a declining tendency. Actinomyces species adsorbed to the tooth surfaces within the first 4 h but did not increase their relative proportions until after 8-12 h, possibly due to a long doubling time. In one individual, encapsulated bacteria resembling Stomatococcus mucilaginosus were observed among the early colonizers. The time-dependent shifts in the bacterial populations within 24 h corroborate parallel ultrastructural findings.

Bacteria↗
PubMed1987

Scanning electron microscopy of early microbial colonization of human enamel and root surfaces in vivo.

This study describes the pattern of microbial colonization in six dental students, who carried test pieces of enamel and root surface in intraoral acrylic appliances for 4, 8, 12, 24, and 48 h, respectively. Oral hygiene was discontinued during the experimental periods. The results showed that oral microorganisms colonized enamel and root surfaces individually. The pattern of colonization mimicked the surface structure of the tooth; on enamel surfaces the first bacteria appeared in pits and surface irregularities followed by proliferation along the perikymata, while on root surfaces bacterial colonization was characterized by a haphazard distribution. Within the initial 24-h period root surfaces were more heavily colonized than were enamel surfaces. This pattern was characteristic irrespective of differences in the intra- and interindividual rates of bacterial coverage. It is concluded that early microbial colonization in vivo is determined by the surface structure of the tooth. Consequently, natural tooth surfaces should not be replaced by artificial surfaces in structural studies of microbial deposits in the oral cavity.

Adult↗
PubMed1987

Transmission electron microscopy of early microbial colonization of human enamel and root surfaces in vivo.

This study describes the early microbial colonization of teeth by the use of light- and transmission electron microscopy. Six dental students carried a total of 60 test pieces of unerupted enamel and root surface in intraoral acrylic appliances for 4, 8, 12, 24 and 48 h, during which periods oral hygiene was abandoned. Pronounced variations were recorded in structure and thickness of the pellicle across the individual surfaces of both dental tissues. Bacterial single-cell colonization increased the electron density of the adjoining pellicle. Micro-colonies of bacteria were observed in relation to enamel surface irregularities such as perikymata, while the distribution on root surfaces appeared incidental. Root surfaces were generally colonized by thicker deposits than homologous enamel surfaces although the structural composition of the microbiota was similar. Gram-positive bacteria with thick cell walls appeared in coccoid or rod-shaped configurations depending on the age of the bacterial deposit. These bacteria were further characterized by selective invasion between collagen fibers. After 48 h the complexity of the microbiota was increased by the establishment of new bacterial species in the superficial layer. It is concluded that the pattern and composition of the early microbiota on teeth is more complex and variable than hitherto assumed.

Bacteria↗